THE PROVIDENCE JOURNAL – 03/19/2003
“The Station” fire’s psychological pain will test survivors and victims’ families for years
A mental-health professional with expertise in mass casualties says Rhode Island responded well from the outset of The Station tragedy, but cautions that the work is not done.
By Felice J. Freyer, Journal Medical Writer
CRANSTON — Survivors of The Station fire and their families face psychological struggles that will continue for years, Brian W. Flynn, a federal expert on mental health after large-scale disasters, told a gathering of Rhode Island mental-health providers yesterday. More …
DAVID S. LAUTERBACH, THE KENT CENTER PRESIDENT/CEO, RECEIVES CEDARR FAMILY CENTER LEADERSHIP ROUNDTABLE AWARD
On December 12, 2002, David S. Lauterbach, President/CEO of Kent County Mental Health Services [now The Kent Center], was presented with CEDARR’s Leadership Roundtable Award:
In recognition of your commitment and vision in coming together with other agencies to incorporated Family Solutions, the second CEDARR Family Center in Rhode Island. Your perseverance and commitment to the goals of the Leadership Roundtable and the CEDARR initiative have enabled the development of services and supports for Rhode Island children with special health care needs and their families.
Family Solutions CEDARR was certified by the Department of Human Services on September 17, 2001. Owned and financially supported by the Quality Care Company, Family Solutions CEDARR is managed by Family Service RI under a management agreement initiated in September 2001.
Family Solutions CEDARR is a program designed to to be a place where families can get information, explore their experience of parenting a child with special challenges, examine their needs and priorities, and be supported in making the best decisions about care for their children. CEDARR services are targeted to families with children who are challenged by Autism, Development Delay, Medical Issues, Medical Technology Dependence, and/or Behavioral Health Issues.
CEDARR stands for: Comprehensive/Evaluation/Diagnosis/Assessment/Referral/
Re-Evaluation. Families experience support and help in creating a care plan to meet the needs of their child and the entire family. The family care plan is designed to reflect the family’s choices, priorities, and needs.
Family Solutions CEDARR serves families from across the State and provides services in the location requested by the family (home, school, community, etc.). One of the primary goals of the program is to link the medical, educational, legal and any other areas of a child and family’s life together into a plan that can be understood and shared by all.
TWO KENT CENTER CLINICIANS FEATURED IN JUNE 2002 ISSUE OF BEHAVIORAL HEALTHCARE TOMORROW
“Moving Services Under One Roof: Providers explore advantages of cross-training staff”
Behavioral Healthcare Tomorrow
Volume 11, No. 3
Article courtesy of Behavioral Healthcare Tomorrow,
Manisses Communications Group, Inc.
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EARLY BIRD TRAINING FOCUSES ON STRESS REDUCTION IN THE WORKPLACE SINCE 9/11
PARI was the site for the first in a series of early-bird training workshops sponsored by the Rhode Island Rehabilitation Association (RIRA) for the continuing education of rehabilitation professionals. The topic of the first workshop was “Stress Reduction in the Workplace Since 9/11,” and was presented by David Lauterbach, President and CEO of Kent County Mental Health.
The events of September 11th were traumatic not only for the people directly involved with them, but also for those who saw the events being played out in the media. Early intervention aster a trauma is critical if post traumatic stress disorder is not to become a problem.
Experiencing post traumatic stress disorder carves a pathway into the brain which can be triggered by a sight, smell, or so forth that recalls the initial incident. Ideally, stress debriefing should happen as soon as possible after a tragedy.
Some ways to manage everyday stress include diet, exercise, medication, and prayer. Quick intervention after a trauma can help prevent post traumatic stress disorder. Stress can be managed if it’s recognized and given proper attention.
THE PARTNERSHIP DEVELOPMENT PROGRAM/SUBSTANCE ABUSE INITIATIVES: First Outcomes Patrick McEneaney
Phoenix Houses of New England and Kent County Mental Health Center [now The Kent Center] are at the midpoint of a pilot collaboration sponsored by the RI Division of Behavioral Healthcare: integrated substance abuse and mental health treatment for clients at Phoenix House’s long term residential treatment center in Exeter, RI.
Like many providers of alcohol and drug abuse treatment, Phoenix House has seen a dramatic increase in the number of dually disordered clients during the 1990s. In recent years, 35% or more of all individuals admitted for residential treatment are already taking psychotropic medication, or are subsequently diagnosed and treated during their residence.
The dropout rate for this group of clients is traditionally high: about 70% leave within the first 30 days. Yet many years of treatment research has demonstrated conclusively that individual outcomes such as abstinence or reductions in AOD use, more days of employment, and few arrests, improve markedly with longer time in treatment. Six to nine months of engagement in most residential and drug-free outpatient treatment modalities is considered optimal.
With this in mind, program directors Debra Jean-Laurent of Phoenix House Exeter and Dayna Gladstein of KCMHC initiated training sessions for Phoenix House staff. Nancy Serabian, MS, RNCS, a KCMHC clinician trained in Dialectical Behavioral Therapy (DBT), and Dayna Gladstein, LICSW, CDP, facilitate the training. The program description and utilization protocol calls for a 20-week curriculum of group sessions for clients, co-facilitated by Kent County and Phoenix House staff. Clients also attend supportive weekly individual sessions and check in daily with their Phoenix House co-facilitator to reinforce the skills that they are learning in the group sessions. The curriculum is built on the concepts of DBT and concentrates on developing skills in four areas: mindfulness of emotions and their intensity, interpersonal communications, modulation of intense emotions, and tolerance of stress.
To date, twenty eligible clients have entered Phoenix House Exeter during the pilot program. Eighteen agreed to try the voluntary program and attended at least one session. Five have already completed the 20-session program – each has been in residence for more than 150 days and each is successfully continuing in the standard thereapeutic community treatment program. Another nine dually disordered residents are currently participating in the 20-session curriculum.
All participating clients, whether they complete the program or not, will be tracked over a one-year period for collection of outcome data. Comparable clients in Phoenix House’s residential treatment programs in Springfield, MA and Dublin, NH, which do not yet have an integrated substance abuse/mental health component, are also being tracked as a comparison group.
“This program fits so nicely in the residential program,” says Phoenix House facilitator Jeff Marsden. “The training gives our therapeutic community meaning to the participants. A large percentage of them have made much better progress in treatment than our average residents.”
One result, he notes, is an improvement in the functioning of the entire treatment community, to the benefit of all residents, whereas previously, both staff and residents believed that dually disordered individuals did not fit well in the community.
These mid-point results are encouraging from several perspectives. As noted earlier, longer times in treatment correlate with better post-treatment outcomes. Financially, the dually-disordered enhancement costs relatively little. Most of the treatment elements are already in place, and only cross-training and the weekly treatment-mental health collaboration are required. In terms of cost benefit, multiple long-term studies have found savings to society of $4 to $12 for every dollar spent on the treatment of a substance abusing client, primarily in reduced emergency services, crime, and criminal justice cost. These savings are compounded when factoring in the increased productivity of a substance abuse client who returns to the workplace, and the long-term benefits that follow from stable parenting and family life.
“The partnership between KCMHC and Phoenix House has established a new paradigm in treating clients with co-occurring disorders,” says Dayna Gladstein of KCMHC. “The benefits of the project are multi-dimensional. The treatment outcomes for clients with co-occurring disorders are improving, the staff of both organizations benefit from the cross-training, and the synergistic atmosphere is strength-focused and motivational for all involved. In the future, this model may be utilized in other treatment settings and by other organizations. Thank you to MHRH for sponsoring this project.”
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